Health Insurance for a Pregnant Woman

Did you know that pregnancy is generally considered a pre-existing condition when it comes to health insurance coverage? In the past, this meant that health insurance companies could deny coverage to women who found themselves in the family way. In some cases, they also charged women more for insurance under the assumption that they could or would get pregnant at some point. These days, discrimination of this sort is no longer legal. Under Obamacare, no one can be denied coverage or overcharged due to a pre-existing condition, and that includes pregnancy. In addition, however, pregnant women are treated as a special group and thus given special consideration. If you find that you are pregnant and in need of health insurance coverage, there are a few things you should know.

The costs of having a baby can be high. Between prenatal visits, special treatments (ultrasounds), extra vitamins, and of course, childbirth, labor, and post-birth doctor appointments, you can spend a pretty penny having a child. But you needn’t fear for your ability to bring a healthy baby into the world. When you sign up for health insurance coverage under the Affordable Care Act (ACA), or Obamacare, you’ll have access to all of the maternity care you need at a cost you can afford.

For starters, you’ll be eligible for a special enrollment period (SEP) when you are pregnant and seeking medical insurance (or necessary changes to your existing policy). This enrollment is actually for your baby, not for you, but it allows you to make sure that your infant is covered beginning the day he/she is born, even if it is outside the public open enrollment period. In addition, you can apply for coverage up to 60 days after the date of birth and still receive benefits (retroactively) from the birth date. This is applicable whether you ultimately elect to keep your current plan and add your child or you decide to change to a different plan.

As for covering costs during your pregnancy, you’ll find that all health insurance plans under Obamacare are required to provide for maternity benefits essential to maintaining the health of mother and child. This is true even if you are already pregnant when you enroll for coverage. You may also be eligible for Medicaid coverage during pregnancy, and your child could qualify for Children’s Health Insurance Program (CHIP) coverage after birth. The benefits you receive will depend on several factors, including your income and the assistance provided by your state of residence, but it’s worth looking into.

It should be noted that these benefits exist under Obamacare, and the rule pertaining to the elimination of pre-existing conditions only took effect in 2014. If you held onto a grandfathered insurance policy, a private (not obtained through a job) individual policy that you had before Obamacare was implemented, your plan may not include essential maternity benefits required by the new law. In some cases, coverage for pre-existing conditions can still be denied under such policies. The best way to avoid this if you are pregnant or plan to become pregnant is to drop your old policy and sign up for a new plan under Obamacare.

Rob Schwab – Insurance Agent

Hi, my name is Robert Schwab. I am a licensed insurance agent with extensive training in the Affordable Care Act and healthcare reform. There have been a lot of health insurance changes recently and I consider it my job to help consumers fully understand their insurance policy. Read More…

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